Health care policy: lessons from the past and issues of the future

Liberal distributional values, the increasingly powerful capacity of medicine to provide more and better care, and concern about the health hazards of an industrial society fueled the vast expansion of the health care sector during the last 20 years. That growth was facilitated by a growing economy. The current health policy debate at one level reexamines the distributional bases of entitlement programs, and at another seeks alternative resource allocation mechanisms to reduce the cost of health care. This article has two themes. First, distributional and allocational policies are shown to be intrinsically related, so that the health policy debate is fundamentally a clash between liberal and libertarian values. Second, the inexorable social forces driving the health care system are shown to be the aging of the population and the rapid expansion of technology. The resulting dynamics imply the further growth of the health sector, now in the environment of a sluggish economy. Future policies will have to struggle with how to ration scarce health resources and how to reorient the health care sector to the problems of the aged.     

Industrial rationalization of a cottage industry: multi-institutional hospital systems

The environment facing hospitals, generally supportive until the 1970s, may now be characterized as complex, turbulent, and constrained. In response to such environmental conditions, hospitals have adopted new strategies and structures. The strategies, described as corporate rationalization, have led away from the traditional structure of freestanding, autonomous hospitals and toward the formation of multi-institutional systems. These systems are designed to provide sufficient strength to cope with the environment, to acquire scarce and valued resources, to allow organizational stability, to achieve organizational purpose, to enable growth and/or survival, and to enhance market position. The impact of multi-hospital systems is viewed in two major areas: acquisition, retention, and utilization of economic and human resources, and organizational, political, and social factors.     

Two Decades of Change: A Ranking of Key Issues Affecting Intergovernmental Relations

This article describes the results of a 1981 survey of 1,000randomly selected scholars of American government and politicswho were asked to rank the most significant intergovernmentalevents and trends of the past twenty years. Responses were receivedfrom almost 40 percent of these scholars; no significant returnbiases were detected. These scholars ranked civil rights andvoting rights acts as the most significant events of these decades.General Revenue Sharing and the reapportionment cases were rankedsecond and third in importance. The increased flow of federaldollars to states and local governments was ranked the mostimportant trend affecting intergovernmental relations, followedby the increased public disaffection with government and thegrowing dependence of local governments on state and federalaid. The Vietnam War and the inflationary spiral it initiatedwas ranked as the most significant social event affecting thecourse of intergovernmental relations, followed closely by theenergy crisis and the beginnings of the "Great Society." Thearticle also examines the effects of party identification, age,year of degree, government experience, region, and city sizeon scholarly attitudes toward these events and trends. Whilethe overall rankings were not dramatically altered, partisanship,region, and city size all were factors found to be noticeablyrelated to scholarly rankings of these important events andtrends.     

The Impact of Electoral Reform: "Open Elections" and the Louisiana Party System

This article examines effects of the "open-elections" law passedby the Louisiana legislature in 1975. The law eliminated traditionalclosed party primaries, creating instead, an open-electionssystem that requires all candidates, regardless of party affiliation,to appear on the same ballot. By and large, the new system hasnot had a significant effect on party competition, party success,or voter turnout in Louisiana.     

C: Reviews and notes bibliographies and works of reference

INTRODUCTORY GUIDE TO MIDDLE EASTERN AND ISLAMIC BIBLIOGRAPHY. (Middle East Libraries Committee Research Guides, 5.) Edited by PAUL AUCHTERLONIE. Oxford, Middle East Libraries Committee, 1990. v, 84pp. £9.50.

SUFI WOMEN. By JAVAD NURBAKHSH. Translated by L. Lewisohn. Rev. ed., London & New York, Khaniqahi‐Nimatullahi Publications, 1990. 263pp. 8 illustrations. £7.95.

WHO'S WHO IN THE ARAB WORLD 1990–1991. Tenth edition, thoroughly revised and completed. München, New York, London, Paris, K.G. Saur, for Publitec Publications, 1990. 927 pp. £180.00

INVENTARIO DE FOLLETOS: SECCIÓN DE ÁFRICA Y MUNDO ÁRABE DE LA BIBLIOTECA NACIONAL, I (CAJAS 7000 A 7021). By JAVIER GÓMEZ LÓPEZ & others. Madrid, Biblioteca Nacional, 1989. 124pp.

BIBLIOGRAFIA DE LA LITERATURA HISPANO‐ARABE. Compiled by MARIA JESUS RUBIERA MATA. Alicante, Universidad de Alicante, 1988. 75pp. Ptas. 566.‐

ESTUDIOS ONOMÁSTICO‐BIOGRÁFICOS DE AL‐ANDALUS, I. Edited by MANUELA MARlN. Madrid, CSIC, Instituto de Filología, Departamento de Estudio Árabes, 1988. 610,[2]pp.

ESTUDIOS ONOMÁSTICO‐BIOGRÁFICOS DE AL‐ANDALUS, II. Edited by MARlA LUISA ÁVILA. Granada, CSIC, Escuela de Estudios Árabes, 1989. 342,[2]pp.

AL‐ADAB AL‐TÜNISI AL‐MU'ASIR. By JEAN FONTAINE. Tunis, al‐Dar al‐Tūnisiyya li‐1‐Nashr, 1989. 191pp. TD3.200.

ENGLISH‐PERSIAN DICTIONARY OF LEGAL AND COMMERCIAL TERMS. Compiled By K.FAHIM, J. HABIBION and F. VITTOR. Leiden, Brill, 1989. 81pp. Hfl 150.

FLORA OF EASTERN SAUDI ARABIA. By JAMES P. MANDAVILLE. London, Kegan Paul International, in association with the National Commission for Wild Life Conservation and Development, Riyadh, 1990. x, 482pp. 200 colour ills. £95.00.     

B. Reviews: general

A HISTORY OF THE ARAB PEOPLES. By ALBERT HOURANI. London, Faber and Faber, 1991. xviii, 551pp. £25 (hb).

STUDIES IN ARAB HISTORY. Edited by DEREK HOPWOOD. (St.Antony's/Macmillan series.) London, Macmillan, 1990. 189pp. 5 plates and 3 figures.

A HISTORY OF THE SELJUKS: ?BRAHIM KAFESOGLU'S INTERPRETATION AND THE RESULTING CONTROVERSY. Translated and edited By GARY LEISER. Carbondale and Edwardsville, Southern Illinois University Press, 1988. 208pp. Genealogical charts, maps in end covers. $29.95.

THE HISTORY OF THE JEWS IN THE LATIN KINGDOM OF JERUSALEM. By JOSHUA PRAWER. Oxford, Clarendon Press, 1988. xv, 310pp. 5 maps.

ARAB HISTORY AND THE NATION STATE: A STUDY IN MODERN ARAB HISTORIOGRAPHY 1820–1980. By YOUSSEF M. CHOUEIRI. (Exeter Arabic and Islamic Series.) London & New York, Routledge, 1989. xix, 238pp. £35.00

THE END OF EMPIRE IN THE MIDDLE EAST: BRITAIN'S RELINQUISHMENT OF POWER IN HER LAST THREE ARAB DEPENDENCIES. By GLEN BALFOUR‐PAUL. Cambridge, Cambridge University Press, 1991. xxiv, 278pp. £30.00.

THE LETTERS OF T.E. LAWRENCE. Edited by MALCOLM BROWN. Oxford, Oxford University Press, 1991. xi, 564pp. £8.95 (pb).

A PRINCE OF OUR DISORDER: THE LIFE OF T.E. LAWRENCE. By JOHN H. MACK. Oxford, Oxford University Press, 1990. xxvi, 561pp. £9.95 (pb).

UN GRAND RABBIN SEPHARADE EN POLITIQUE 1892–1923. Presented and edited by ESTHER BENBASSA. Mesnil‐sur‐l'Estrée, CNRS, 1990. 263pp.

THE SUPREME MUSLIM COUNCIL: ISLAM UNDER THE BRITISH MANDATE FOR PALESTINE. By URI M. KUPFERSCHMIDT. Leiden, Brill, 1987.

AFTER THE EAGLES LANDED: THE YEMENITES OF ISRAEL. By HERBERT S. LEWIS. Boulder, Westview Press, 1989. xix, 277pp., photographs, glossary.

LAND BEFORE HONOUR: PALESTINIAN WOMEN IN THE OCCUPIED TERRITORIES. By KITTY WARNOCK. (Women in Society: A Feminist List.) London, Macmillan Educational Press, 1990. 199pp.

PEASANT POLITICS IN MODERN EGYPT: THE STRUGGLE AGAINST THE STATE. By NATHAN BROWN. New Haven and London, Yale University Press, 1990. 280pp. 2 maps. £25.00.

SOCIETY AND STATE IN THE GULF AND ARAB PENINSULA. By KHALDOUN HASAN AL‐NAQEEB. London and New York, Routledge, 1990. xvii, 206 pp. £35

THE TURBULENT GULF. By LIESL GRAZ. London, I.B. Tauris, 1990. xi, 312pp. £17.95.

IRAN: THE KHOMEINI REVOLUTION (COUNTRIES IN CRISIS). Edited by MARTIN WRIGHT. Contributors: Nick Danziger, Martin Howe, Baqer Moin, Reza Navabpour, Sir Anthony Parsons, Vahe Petrossian, Amit Roy and Martin Wright. London, Longman, 1989. 128pp. Maps, ills. £6.95.

ISRAEL AND THE PALESTINIANS (COUNTRIES IN CRISIS). Edited by MARTIN WRIGHT. Contributors: Paul Cossali, Roger Hardy, Lawrence Joffe, Noah Lucas, David McDowall, Elfi Pallis, Martin Wright. London, Longman, 1989. 131pp. Maps, ills. £6.95.

MAJOR POLITICAL EVENTS IN IRAN, IRAQ AND THE ARABIAN PENINSULA 1945–1990. By TREVOR MOSTYN. New York & London, Facts on File, 1991. xii, 308pp. £14.95.

WOMEN AT WORK IN THE GULF: A CASE STUDY OF BAHRAIN. By MUNIRA A. FAKHRO. London, Kegan Paul International. 184pp. £45.00

THE POLITICAL ECONOMY OF TURKEY: DEBT, ADJUSTMENT AND SUSTAINABILITY. Edited by TOSUN ARICANLI and DANI RODRIK. Basingstoke, Macmillan, 1990. 275pp. £40 (hb).

AFGHANISTAN: A COUNTRY LAW STUDY. By GHOLAM H. VAFAI. Washington, Library of Congress, 1988. 63pp.

RESISTANCE AND CONTROL IN PAKISTAN. By AKBAR S. AHMED. London & New York, Routledge, 1991. xxiii, 207pp. £12.99 (pb).

MASTERING ARABIC: By JANE WIGHTWICK and MAHMOUD GAAFAR. (Macmillan Master Series.) London, Macmillan, 1990. 370pp.

FROM CODE‐SWITCHING TO BORROWING: A CASE STUDY OF MOROCCAN ARABIC. By JEFFREY HEATH. (Library of Arabic Linguistics, monograph 9.) London, Kegan Paul International, 1990. 328pp.

ARISTOTELIAN LOGIC AND THE ARABIC LANGUAGE IN ALFARABI. By SHUKRI B. ABED. Albany, State University of New York Press, 1991. xxv, 201pp.

OGHUSICA AUS IRAN. By GERHARD DOERFER, WOLFRAM HESCHE, JAMSHID RAVANYAR. Wiesbaden, Harrassowitz, 1990. ix, 146pp. DM 56.‐

ABBASID BELLES LETTRES. Edited by Julia Ashtiany, T.M. Johnstone, J.D. Latham, R.B. Serjeant and G. Rex Smith. (The Cambridge History of Arabic Literature, Vol.II, 1.) Cambridge, Cambridge University Press, 1990. xiii, 517pp.

PENSEE MYTHIQUE, IDEOLOGIE ET ASPIRATIONS SOCIALES DANS UN CONTE DES MILLE ET UNE NUITS. By PATRICE COUSSONNET. (Supplément aux Annales Islamologiques—Cahier no. 13). Cairo, Institut français d'archéologie orientale, 1989. 67 pp. 6 plates.

THE MEADOWS OF GOLD: THE ABBASIDS. By MAS'UDI. Tr. and ed. by PAUL LUNDE and CAROLINE STONE. London and New York, Kegan Paul International, 1989. x, 469pp. £30.00

POESlA ESTRÓFICA (CEJELES Y/O MUWA??AHAT) ATRIBUIDA AL MlSTICO GRANADINO A?‐?u?TARI (SIGLO XIII d.C.).(Preedición, traducción, estudio e índices.) By F. CORRIENTE. Madrid, CSIC, Instituto de Filología, Departamento de Estudios Árabes, 1988. [6], 379pp.

ISLAM, THE STRAIGHT PATH. By JOHN L. ESPOSITO. Oxford University Press, 1988. viii, 230pp. £6.95.

TRADITIONAL ISLAM IN THE MODERN WORLD. By SEYYED HOSSEIN NASR. London, KPI, 1987. x, 335pp.

IN A CALIPH'S KITCHEN: MEDIAEVAL ARABIC COOKING FOR THE MODERN GOURMET. By DAVID WAINES. London, Riad el‐Rayyes Books, 1989. 119pp. 44 colour plates. £14.00.